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Post-polypectomy bleeding and thromboembolism risks associated with warfarin vs direct oral anticoagulants

World Journal of Gastroenterology 2018年第14期24卷 1540-1549页

作者： Naohiro Yanagisawa Naoyoshi Nagata Kazuhiro Watanabe tatsuhiro iida Mariko Hamada Sakurako Kobayashi Takuro Shimbo Junichi Akiyama Naomi Uemura Department of Gastroenterology and Hepatology National Center for Global Health and MedicineTokyo 162-8655Japan Ohta Nishinouchi Hospital Fukushima 963-8022Japan Department of Gastroenterology and Hepatology National Center for Global Health and MedicineKohnodai HospitalChiba 272-8516Japan

AIM To verify the validity of the endoscopy guidelines for patients taking warfarin or direct oral anticoagulants(DOAC).METHODS We collected data from 218 patients receiving oral anticoagulants(73 DOAC users, 145 warfarin users) and 218 patients not receiving any antithrombotics(age-and sexmatched controls) who underwent polypectomy.(1) We evaluated post-polypectomy bleeding(PPB) risk in patients receiving warfarin or DOAC compared with controls;(2) we assessed the risks of PPB and thromboembolism between three AC management methods: Discontinuing AC with heparin bridge(HPB)(endoscopy guideline recommendation), continuing AC, and discontinuing AC without *** PPB rate was significantly higher in warfarin users and DOAC users compared with controls(13.7% and 13.7% vs 0.9%, P < 0.001), but was not significantly different between rivaroxaban(13.2%), dabigatran(11.1%), and apixaban(13.3%) users. Two thromboembolic events occurred in warfarin users, but none in DOAC users. Compared with the continuing anticoagulant group, the discontinuing anticoagulant with HPB group(guideline recommendation) had a higher PPB rate(10.8% vs 19.6%, P = 0.087). These findings were significantly evident in warfarin but not DOAC users. One thrombotic event occurred in the discontinuing anticoagulant with HPB group and the discontinuing anticoagulant without HPB group; none occurred in the continuing anticoagulant *** PPB risk was similar between patients taking warfarin and DOAC. Thromboembolism was observed in warfarin users only. The guideline recommendations for HPB should be re-considered.

关键词： High-risk endoscopic procedures Novel oral anticoagulants Endoscopic guideline validation Postprocedure gastrointestinal bleeding

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Anti-Obesity Effects of Dietary d-Allulose and Medium-Chain Triglycerides in High-Fat Diet-Fed Rats

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Food and Nutrition Sciences 2024年第8期15卷 701-710页

作者： tatsuhiro Matsuo Chihiro Yokoyama Takako Yamada Tetsuo iida Susumu Mochizuki Akihide Yoshihara Kazuya Akimitsu Faculty of Agriculture Kagawa University Miki-cho Japan Research and Development Matsutani Chemical Industry Co. Ltd. Itami Japan

d-Allulose, a rare sugar, exerts anti-obesity effects by inhibiting hepatic lipogenesis and promoting energy expenditure. Medium-chain triglycerides (MCTs) consist of three medium-chain fatty acids connected by glycerol. MCTs have been extensively investigated for their ability to reduce body fat accumulation. We previously investigated the anti-obesity effects of a combination of dietary d-allulose and MCT (5% - 13%) in rats;however, we could not confirm the anti-obesity effects of MCT or observed synergetic effects between d-allulose and MCT on body fat loss. We speculated that our previous studies were influenced by the excessive amount of MCT in the diets. Therefore, in this study, we aimed to investigate the anti-obesity effects of the simultaneous intake of d-allulose and MCT in rats fed an obesity-inducing high-fat diet with a low amount of MCTs (2%). Thirty-two male Wistar rats (3-week-old) were randomly divided into four groups: control, d-allulose, MCT, and d-allulose + MCT groups. Rats in each group were fed ad libitum on a control (no d-Allulose or MCT), 5% d-allulose, 2% MCT, or 5% d-allulose + 2% MCT diets for 16 weeks. Abdominal adipose tissue weights were significantly lower in the d-allulose diet group than in the control group, whereas no differences were observed between results of the MCT-supplemented groups. The total body fat mass was significantly lower in the d-allulose and MCT diet groups than in the control group, but no differences were observed between the MCT-supplemented groups. These results suggested that anti-obesity effects of dietary d-allulose were observed, and the effects of dietary MCTs were weaker than those of d-allulose. Moreover, we confirmed the interaction between dietary d-allulose and MCT on indicators of obesity. Interestingly, their effects were not synergistic, as MCT supplementation offset the anti-obesity effects of dietary d-allulose. However, the specific mechanisms underlying those effects remain unknown, warran

关键词： Rare Sugar d-Allulose Medium-Chain Triglycerides Body Fat Rat

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